In the last days of life

In the last days of life;

Consider using an end of life care pathway such as the Liverpool Care Pathway.

Prescribe PRN drugs as described below in anticipation of anxiety or distress caused by breathlessness. Many patients will become unable to take drugs by the oral route so prescribe medication to be given parenterally e.g. subcutaneously.

Consider stopping or reducing clinical (artificial) hydration if this is causing fluid overload leading to pulmonary oedema or excessive upper airway secretions.